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Published in: Aesthetic Plastic Surgery 4/2013

01-08-2013 | Original Article

Comparison of the Effects of Columellar Strut and Septal Extension Grafts for Tip Support in Rhinoplasty

Authors: Ali Murat Akkus, Erhan Eryilmaz, Ethem Guneren

Published in: Aesthetic Plastic Surgery | Issue 4/2013

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Abstract

Background

The purpose of this study was to compare the effects of columellar strut and septal extension grafts for reconstruction of caudal nasal supportive structures on the long-term stability of nasal projection and rotation.

Methods

A comparison was done on the differences between the early- and long-term results of the ratios of nasal projection to nasal length and columella labial angle values in 36 patients who were operated on by the same surgeon using columellar or septal extension grafts.

Results

Both grafts had the effect of increasing nasal projection, and this effect was found to be stable over time. Some increased values of nasal projection obtained in the early postoperative period were lost over time. Although no significant difference was found between the groups, clinical and numerical observations showed that the values decreased less in the group that received septal extension grafts.

Conclusion

The tip position was more stable in cases with septal extension grafts than in those with columellar strut grafts.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266.
Literature
1.
go back to reference Whitaker IS, Karoo RO, Richard O, Spyrou G, Fenton OM (2007) The birth of plastic surgery: the story of nasal reconstruction from the Edwin Smith Papyrus to the twenty-first century. Plast Reconstr Surg 120:327–336PubMedCrossRef Whitaker IS, Karoo RO, Richard O, Spyrou G, Fenton OM (2007) The birth of plastic surgery: the story of nasal reconstruction from the Edwin Smith Papyrus to the twenty-first century. Plast Reconstr Surg 120:327–336PubMedCrossRef
2.
go back to reference Howard B, Rohrich RJ (2002) Understanding the nasal airway: principles and practice. Plast Reconstr Surg 109:1128–1146PubMedCrossRef Howard B, Rohrich RJ (2002) Understanding the nasal airway: principles and practice. Plast Reconstr Surg 109:1128–1146PubMedCrossRef
3.
go back to reference Sheen JH (2000) Rhinoplasty: personal evolution and milestones. Plast Reconstr Surg 105:1820–1852PubMedCrossRef Sheen JH (2000) Rhinoplasty: personal evolution and milestones. Plast Reconstr Surg 105:1820–1852PubMedCrossRef
5.
go back to reference Mowlavi A, Masouem S, Kalkanis J, Guyuron B (2006) Septal cartilage defined implications for nasal dynamics and rhinoplasty. Plast Reconstr Surg 117:2171–2174PubMedCrossRef Mowlavi A, Masouem S, Kalkanis J, Guyuron B (2006) Septal cartilage defined implications for nasal dynamics and rhinoplasty. Plast Reconstr Surg 117:2171–2174PubMedCrossRef
6.
go back to reference Rohrich RJ, Ghavami A (2009) Rhinoplasty for Middle Eastern noses. Plast Reconstr Surg 123:1343–1354PubMedCrossRef Rohrich RJ, Ghavami A (2009) Rhinoplasty for Middle Eastern noses. Plast Reconstr Surg 123:1343–1354PubMedCrossRef
7.
go back to reference Pawar SS, Garcia GJ, Kimbell JS, Rhee JS (2010) Objective measures in aesthetic and functional nasal surgery: perspectives on nasal form and function. Fac Plast Surg 26:320–327CrossRef Pawar SS, Garcia GJ, Kimbell JS, Rhee JS (2010) Objective measures in aesthetic and functional nasal surgery: perspectives on nasal form and function. Fac Plast Surg 26:320–327CrossRef
8.
go back to reference Özmen S, Ayhan S (2008) Upper lateral cartilage fold-in flap: a combined spreader and/or splay graft effect without cartilage grafts. Ann Plast Surg 61:527–532PubMedCrossRef Özmen S, Ayhan S (2008) Upper lateral cartilage fold-in flap: a combined spreader and/or splay graft effect without cartilage grafts. Ann Plast Surg 61:527–532PubMedCrossRef
9.
go back to reference Gunter JP, Landecker A, Cochran CS (2006) Frequently used grafts in rhinoplasty: nomenclature and analysis. Plast Reconstr Surg 118:14e–29ePubMedCrossRef Gunter JP, Landecker A, Cochran CS (2006) Frequently used grafts in rhinoplasty: nomenclature and analysis. Plast Reconstr Surg 118:14e–29ePubMedCrossRef
10.
go back to reference Rohrich RJ, Raniere J Jr, Ha RY (2002) The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 109:2495–2505 (discussion 2506–2508)PubMedCrossRef Rohrich RJ, Raniere J Jr, Ha RY (2002) The alar contour graft: correction and prevention of alar rim deformities in rhinoplasty. Plast Reconstr Surg 109:2495–2505 (discussion 2506–2508)PubMedCrossRef
11.
go back to reference Ghavami A, Janis JE, Açıkel C, Rohrich RJ (2008) Tip shaping in primary rhinoplasty: an algorithmic approach. Plast Reconstr Surg 122:1229–1241PubMedCrossRef Ghavami A, Janis JE, Açıkel C, Rohrich RJ (2008) Tip shaping in primary rhinoplasty: an algorithmic approach. Plast Reconstr Surg 122:1229–1241PubMedCrossRef
12.
go back to reference Guyuron B, Behmand RA (2003) Nasal tip sutures, Part II: the interplays. Plast Reconstr Surg 112:1130–1145 (discussion 1146–1149)PubMedCrossRef Guyuron B, Behmand RA (2003) Nasal tip sutures, Part II: the interplays. Plast Reconstr Surg 112:1130–1145 (discussion 1146–1149)PubMedCrossRef
13.
go back to reference Behmand RA, Ghavami A, Guyuron B (2003) Nasal tip sutures, Part I: the evolution. Plast Reconstr Surg 112:1125–1131PubMedCrossRef Behmand RA, Ghavami A, Guyuron B (2003) Nasal tip sutures, Part I: the evolution. Plast Reconstr Surg 112:1125–1131PubMedCrossRef
14.
go back to reference Guyuron B, Jackowe D (2007) Modified tip grafts and tip punch devices. Plast Reconstr Surg 120:2004–2010PubMedCrossRef Guyuron B, Jackowe D (2007) Modified tip grafts and tip punch devices. Plast Reconstr Surg 120:2004–2010PubMedCrossRef
15.
go back to reference Byrd HS, Andochick S, Copit S, Walton KG (1997) Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 100:999–1010PubMedCrossRef Byrd HS, Andochick S, Copit S, Walton KG (1997) Septal extension grafts: a method of controlling tip projection shape. Plast Reconstr Surg 100:999–1010PubMedCrossRef
16.
go back to reference Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111:1533–1539 (discussion 1540–1541)PubMedCrossRef Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111:1533–1539 (discussion 1540–1541)PubMedCrossRef
17.
go back to reference Ha RY, Byrd HS (2003) Septal extension grafts revisited: 6-year experience in controlling nasal tip projection and shape. Plast Reconstr Surg 112:1929–1935PubMedCrossRef Ha RY, Byrd HS (2003) Septal extension grafts revisited: 6-year experience in controlling nasal tip projection and shape. Plast Reconstr Surg 112:1929–1935PubMedCrossRef
18.
go back to reference Seyhan A, Ozden S, Ozaslan U, Sir E (2007) A simplified use of septal extension graft to control nasal tip projection. Aesthet Plast Surg 31:506–511CrossRef Seyhan A, Ozden S, Ozaslan U, Sir E (2007) A simplified use of septal extension graft to control nasal tip projection. Aesthet Plast Surg 31:506–511CrossRef
19.
go back to reference Kim JS, Han KH, Choi TH, Kim NG, Lee KS, Son DG, Kim JH (2007) Correction of nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique. J Plast Reconstr Aesthet Surg 60:163–170PubMedCrossRef Kim JS, Han KH, Choi TH, Kim NG, Lee KS, Son DG, Kim JH (2007) Correction of nasal tip and columella in Koreans by a complete septal extension graft using an extensive harvesting technique. J Plast Reconstr Aesthet Surg 60:163–170PubMedCrossRef
20.
go back to reference Kuran İ, Tümerdem B, Tosun U, Yildiz K (2005) Evaluation of the effects of tip-binding sutures an cartilaginous grafts on tip projection and rotation. Plast Reconstr Surg 116:282–288PubMedCrossRef Kuran İ, Tümerdem B, Tosun U, Yildiz K (2005) Evaluation of the effects of tip-binding sutures an cartilaginous grafts on tip projection and rotation. Plast Reconstr Surg 116:282–288PubMedCrossRef
21.
go back to reference Pastorek NJ, Bustillo A, Murphy MR, Becker DG (2005) The extended columellar strut-tip graft. Arch Fac Plast Surg 7:176–184CrossRef Pastorek NJ, Bustillo A, Murphy MR, Becker DG (2005) The extended columellar strut-tip graft. Arch Fac Plast Surg 7:176–184CrossRef
22.
go back to reference Wise JB, Becker SS, Sparano A, Steiger J, Becker DG (2006) Intermediate crural overlay in rhinoplasty: a deprojection technique that shortens the medial leg of the tripod without lengthening the nose. Arch Fac Plast Surg 8:240–244CrossRef Wise JB, Becker SS, Sparano A, Steiger J, Becker DG (2006) Intermediate crural overlay in rhinoplasty: a deprojection technique that shortens the medial leg of the tripod without lengthening the nose. Arch Fac Plast Surg 8:240–244CrossRef
23.
go back to reference Pensler JM (2006) The septal strut for nasal projection following closed rhinoplasty. Aesthet Surg J 26:275–279PubMedCrossRef Pensler JM (2006) The septal strut for nasal projection following closed rhinoplasty. Aesthet Surg J 26:275–279PubMedCrossRef
24.
go back to reference Rohrich RD, Hoxworth RE, Kurkjian TJ (2012) The role of columellar strut in rhinoplasty: indications and rationale. Plast Reconstr Surg 129:118e–125ePubMedCrossRef Rohrich RD, Hoxworth RE, Kurkjian TJ (2012) The role of columellar strut in rhinoplasty: indications and rationale. Plast Reconstr Surg 129:118e–125ePubMedCrossRef
25.
go back to reference Apaydin F, Akyildiz S, Hecht DA, Toriumi DM (2009) Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Fac Plast Surg 11:209–211 Apaydin F, Akyildiz S, Hecht DA, Toriumi DM (2009) Rhinobase: a comprehensive database, facial analysis, and picture-archiving software for rhinoplasty. Arch Fac Plast Surg 11:209–211
26.
go back to reference Ingels K, Orhan KS (2006) Measurement of preoperative and postoperative nasal tip rotation. Arch Fac Plast Surg 8:411–415CrossRef Ingels K, Orhan KS (2006) Measurement of preoperative and postoperative nasal tip rotation. Arch Fac Plast Surg 8:411–415CrossRef
27.
go back to reference Spörri S, Simmen D, Briner HR, Jones N (2004) Objective assessment of tip projection and the columella labial angle in rhinoplasty. Arch Fac Plast Surg 6:295–298CrossRef Spörri S, Simmen D, Briner HR, Jones N (2004) Objective assessment of tip projection and the columella labial angle in rhinoplasty. Arch Fac Plast Surg 6:295–298CrossRef
28.
go back to reference Sadeghi M, Saedi B, Arvin Sazegar A, Amiri M (2009) The role of columellar struts to gain and maintain tip projection and rotation: a randomized blinded trial. Am J Rhinol Allergy 23:e47–e50PubMedCrossRef Sadeghi M, Saedi B, Arvin Sazegar A, Amiri M (2009) The role of columellar struts to gain and maintain tip projection and rotation: a randomized blinded trial. Am J Rhinol Allergy 23:e47–e50PubMedCrossRef
29.
go back to reference Rohrich RJ, Kurkjian TJ, Hoxworth RE, Stephan PJ, Mojallal A (2012) The effect of the columellar strut graft on nasal tip position in primary rhinoplasty. Plast Reconstr Surg 130:926–932PubMedCrossRef Rohrich RJ, Kurkjian TJ, Hoxworth RE, Stephan PJ, Mojallal A (2012) The effect of the columellar strut graft on nasal tip position in primary rhinoplasty. Plast Reconstr Surg 130:926–932PubMedCrossRef
30.
go back to reference Erdem T (2010) Long-term effectiveness of projection control suture in rhinoplasty. Rhinology 48:189–194PubMed Erdem T (2010) Long-term effectiveness of projection control suture in rhinoplasty. Rhinology 48:189–194PubMed
31.
go back to reference Petroff MA, McCollough EG, Hom D, Anderson JR (1991) Nasal tip projection. Quantitative changes following rhinoplasty. Arch Otolaryngol Head Neck Surg 117:783–788PubMedCrossRef Petroff MA, McCollough EG, Hom D, Anderson JR (1991) Nasal tip projection. Quantitative changes following rhinoplasty. Arch Otolaryngol Head Neck Surg 117:783–788PubMedCrossRef
32.
go back to reference Tercan M, Celik E (2009) The evaluation of transseptal transfixion incision for preservation of the nasal tip projection. Ann Plast Surg 62:609–612PubMedCrossRef Tercan M, Celik E (2009) The evaluation of transseptal transfixion incision for preservation of the nasal tip projection. Ann Plast Surg 62:609–612PubMedCrossRef
33.
34.
go back to reference McCollough EG, Mangat D (1981) Systematic approach to correction of the nasal tip in rhinoplasty. Arch Otolaryngol 107:12–16PubMedCrossRef McCollough EG, Mangat D (1981) Systematic approach to correction of the nasal tip in rhinoplasty. Arch Otolaryngol 107:12–16PubMedCrossRef
35.
go back to reference Armijo BS, Brown M, Guyuron B (2012) Defining the ideal columella labial angle. Plast Reconstr Surg 129:759–764PubMedCrossRef Armijo BS, Brown M, Guyuron B (2012) Defining the ideal columella labial angle. Plast Reconstr Surg 129:759–764PubMedCrossRef
Metadata
Title
Comparison of the Effects of Columellar Strut and Septal Extension Grafts for Tip Support in Rhinoplasty
Authors
Ali Murat Akkus
Erhan Eryilmaz
Ethem Guneren
Publication date
01-08-2013
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 4/2013
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-013-0141-1

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